The story behind America's deadliest drug epidemic

New book about the painkiller industry has already been optioned by Warner Bros.

Author and journalism professor John Temple takes a look at the painkiller industry in his new book.
(Photo: David Smith/West Virginia University)

A gold Toyota Camry is stuck on the tracks at a railroad crossing. Two hundred yards away, a train is barreling down, speedily approaching. Stunned commuters stop their cars, awaiting the inevitable.

Thus begins "American Pain: How a Young Felon and His Ring of Doctors Unleashed America's Deadliest Drug Epidemic." The heart-racing opening scene grabs the reader by the lapel and never lets go until the book's satisfying conclusion. It's a riveting non-fiction book that reads like a James Patterson thriller.

Publishers Weekly selected "American Pain" as one of its Big Indie Books of the fall. Warner Bros. has already optioned the movie rights.

What might surprise you, though is the man behind the tome. John Temple is a mild-mannered tenured journalism professor who often speaks so softly that you have to lean in to hear him.

"I can make anything sound boring," he says jokingly one recent afternoon on the campus of West Virginia University where he teaches at the Reed College of Media. But don't let the self-deprecation fool you. The 45-year-old knows how to weave a good yarn.

The author of two previous books, Temple's latest tracks the rise and ultimate fall of a band of young friends who created the largest pill mill in America. Circumventing lax laws and skirting others, they opened a Florida pain clinic that prescribed almost 20 million pills over two years. Thousands of patients streamed through their doors each day, past muscle head security guards and to former strippers who operated the on-site pharmacy. Some of the free-wheeling, script-writing doctors carried guns under their lab coats.

At the helm of the operation were 27-year-old Chris George and his buddy, Derik Nolan. They were more used to being on construction sites than running medical practices. And they were the kingpins in this real-life tale of "Breaking Bad" in Broward County.

What drew Temple to the story was a local connection. The Florida pain clinic attracted addicts from Kentucky and his home state of West Virginia. "It's a national epidemic, but the rate of addiction and overdose death is greater in West Virginia than just about anywhere else," he says after class one day, the hills of Appalachia visible through the window. "I've seen it with students of mine. I've seen it with friends. I feel like almost everyone I talk to knows someone that has a serious problem with it."

The more Temple dug into the story, the more it astounded him. While oxycodone was around for decades, it really wasn't until the 1990s when doctors began prescribing it en masse and spawned a new generation of addicts. "These drugs had always been thought of as a drug of last resort, a dangerous drug, that you should only give to someone who was in a temporary situation, or a terminal situation like a cancer patient, or for someone in a car accident, to allow them to rest and heal," Temple explains.

But instead, doctors were doling it out to anyone who complained of an ache or pain. Since the drug is an opioid, eventually many patients became addicted. The DEA regulates how much oxycodone a pharmaceutical manufacturer is allowed to produce each year. In 1993, that number was around 3,500 kilograms. Now, it's about 140,000 kilograms. "It's a modern-day phenomenon," he says.

Temple sees himself as a storyteller. Indeed, he often employs screenwriting techniques in his journalism classes. He was considering what was the best way to draw an audience into this national tale about a drug epidemic? And then, like karma, he stumbled onto a news article one day in 2012 that caught his attention. "When I saw this story about a guy who had no medical background, no college degree, and a felony drug record, who started up a pain clinic and hired a bunch of doctors and built the biggest pill mill in the country, I thought this was a really interesting way to tell the story," he says.

He got to work immediately. At first, he was reading any book he could find on the topic of painkillers. He attended a medical conference and spoke with experts. Eventually, he traveled to Kentucky and Florida to interview those who had been to the clinic, and those who had lost family members to the drug. He pored over court transcripts, and (spoiler alert!) conducted jailhouse interviews with the cohorts who ran the clinic. He took a semester sabbatical to put all the pieces together. And "American Pain" was born.

Temple is out promoting the book now — traveling to California, Kentucky, Florida and Pennsylvania. He's been chatting with Melisa Wallack, the Oscar-nominated writer of "The Dallas Buyers Club." She's been hired by Warner Bros. to write the screenplay for "American Pain." And he's back to teaching, guiding future journalists in the best ways to tell a story.

And he's keeping an eye out for a new book subject. "When I finish a book, I always worry that I won't come across another story as interesting," he says, before adding: "But something always crops up."